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Published on: August 1, 2019
Development and Evaluation of a Novel Approach to Patient-Centered Contraceptive Counseling
Katharine O White1, Kelly M Treder1, Placidina Fico2
1Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts; Chobanian & Avedisian School of Medicine, Boston University, Boston, Massachusetts.
Objectives:
We aimed to develop and evaluate a novel model, PHI CARE, that provides a standardized framework for shared decision-making in contraceptive counseling.
Methods:
We developed the PHI CARE model with national experts, piloted it at three family planning clinics, and finalized it following additional patient and clinician review. We recruited pregnancy-capable people for an evaluation study via simulated contraceptive counseling and identified salient themes through inductive and deductive coding.
Results:
Participants (n = 12) felt that counseling with the PHI CARE model was an improvement over previous counseling experiences and led to feelings of empowerment; participants did not feel pressured to decide about method use, felt in control during the conversation, and appreciated the absence of assumptions about their desires around pregnancy. Despite the standardized format, participants felt the counseling was individualized, "values-based," and tailored to their preferences.
Conclusion:
PHI CARE is a model to support clinicians and counselors in operationalizing the principles of shared decision-making in contraceptive counseling. Through standardization, PHI CARE allows for a more individualized experience for patients and addresses many critiques of traditional counseling.
Practice Implications:
PHI CARE is a memorable, brief tool that can be used for patient-centered contraceptive counseling in any clinical encounter.
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